Abol Nasr, L., Raafat, S., Narsha, M., Ezzat, S., Khachaba, Y. (2020). Modification of the Basal View after Internal Alar Reduction. The Egyptian Journal of Plastic and Reconstructive Surgery, 44(3), 453-462. doi: 10.21608/ejprs.2020.122308
Laila Abol Nasr; Sarah S Raafat; Motaz Narsha; Sherif Z Ezzat; Youssef Khachaba. "Modification of the Basal View after Internal Alar Reduction". The Egyptian Journal of Plastic and Reconstructive Surgery, 44, 3, 2020, 453-462. doi: 10.21608/ejprs.2020.122308
Abol Nasr, L., Raafat, S., Narsha, M., Ezzat, S., Khachaba, Y. (2020). 'Modification of the Basal View after Internal Alar Reduction', The Egyptian Journal of Plastic and Reconstructive Surgery, 44(3), pp. 453-462. doi: 10.21608/ejprs.2020.122308
Abol Nasr, L., Raafat, S., Narsha, M., Ezzat, S., Khachaba, Y. Modification of the Basal View after Internal Alar Reduction. The Egyptian Journal of Plastic and Reconstructive Surgery, 2020; 44(3): 453-462. doi: 10.21608/ejprs.2020.122308
Modification of the Basal View after Internal Alar Reduction
The Department of Plastic Surgery, Faculty of Medicine, Cairo University, Egypt
Abstract
Background: Numerous alar base modification techniques have been reported in the literature. Specifically, three different
techniques were described to manage cases with alar flaring
in addition to a wide nasal base. Tissue excision from the alar lobule as well as from the inside of the nostril is executed to decrease the alar flaring and the nostril width, respectively. Further techniques include cinching sutures that help advance the alae together and flap advancement. The aim of this study is to emphasize the aesthetic impact of the basal nasal view and to reach a maximum aesthetic result concerning nasal alar flare. Patients and Methods: A prospective study was conducted on 25 patients. All patients had alar flaring seeking alar reduction, either alone or as a part of a full rhinoplasty. During rhinoplasty, alar base reduction was done at the end of rhinoplasty surgery, after the closure of all rhinoplasty incisions and after osteotomy was done. A caliper was used to sharply stab the skin from the lateral limb to the desired sill crease to determine the medial limb of the triangular wedge to be excised. The base of the triangular wedge was directed downward and the apex was directed intra-nasally. Results: The current study showed that the internal alar resection significantly decrease the alar flare; as the inter-alar distance ranged between (35-43mm), Mean±SD (39.2±2.3) before surgery and becomes between (31-37mm) Mean±SD (34.8±2.0) after the surgery, with a significant improvement (p-value: <0.001). Conclusion: Internal alar resection effectively reduced the alar flare, and improved the nostril shape and width. This technique was also useful to retain symmetry of nostril shape, hide the scars internally in the nose, avoid the injury of the lateral nasal artery, preserve the natural curvature of alar rim and avoid detachment of the alar foot plate. This technique can effectually be applied to all patients with alar flare reduction
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